Tuesday, October 20, 2009

Health Care Reform in the USA

All People's Health Care should be covered, as in other countries.

I think that a Single Payer is the vehicle that we should employ, with HUGE CAVEATS.

I worked in the Health Care Finance field for 15 years, mostly as a Utilization and Cost Analyst for "Managed Care" companies. While Physicians for a National Health Plan (PNHP) makes good and valid arguments for a single payer system, they neglect to address the massive fraud and abuse on the Provider side of the health care "INDUSTRY". The massive greed of physicians and the over-supply manifestations of the "medical industrial complex" have caused the USA to have, by far, the highest cost medical system in the world, with poor results due to a preponderance of bureaucracy and the revenue driven bias towards maximum intervention leading to "damaged care" and waste.

We need a single payer with VERY TIGHT budget controls (huge rollbacks on medical spending). We could evolve to a single payer by mandating a public option in all places where insurance coverage is offered and expanding Medicare to everyone else.

But fee for service medicine has got to go. Regional HMOs need to be established with budgets being phased down by 35 to 40% in the next 10 to 20 years. Medical policy boards to oversee the formulation and implementation of such budgets, as caring physicians who understand the cost and abuse issues need to be put in charge of resource allocation policies and administration.

Hospitals and Hospital Corporations need to consolidate their resources into a unified organization so that rational resource allocation and the necessary winnowing out of over-competitive redundancies can be carried out.

Then there are the issues of environmental and public health, the subject of another HUGE discussion.

Mike Morin
Eugene, OR, USA
(541) 343-3808

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